• 제목/요약/키워드: Physician Characteristics

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일개 종합병원 외래환자의 진료시간 및 진료대기시간 영향요인 분석 (Factors influencing consultation time and waiting time of ambulatory patients in a tertiary teaching hospital)

  • 황지인
    • 한국의료질향상학회지
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    • 제12권1호
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    • pp.6-16
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    • 2006
  • Objectives : The purpose of this study was to identify the characteristics influencing consultation and waiting time in ambulatory patients. Methods : This study was conducted in a tertiary teaching hospital. Subjects were a total of 10,383 ambulatory patients. Consultation time was measured by time spent for meeting with his/her physician per patient. Waiting time was defined as the time difference between each patient's reserved time and time to meet with his/her physician for ambulatory care. Multiple regression analyses were performed to determine the factors influencing consultation and waiting time. Results : Consultation time was different according to patient' age, previous experience of clinic visit, recent admission history, medical department, specialist care, type of reservation, and day of the week. Significant factors influencing waiting time were patient' age, residential area, previous experience of clinic visit, recent admission history, medical department, specialist care, time spent after ambulatory care begins, and day of the week. Conclusions : The medical department was the strongest factor affecting both consultation time and waiting time. The ambulatory reservation management systems should take into account patient characteristics as well as care-related features.

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병원의 특성에 따른 의료 인력의 진료 생산성 결정요인 (Factors Affecting Productivity of Medical Personnel in Training Hospital)

  • 이명근
    • Journal of Preventive Medicine and Public Health
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    • 제20권1호
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    • pp.56-66
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    • 1987
  • Information on productivity of hospital personnel is required for optimum staffing and hospital management. This study deals with the quantitative aspects of workload of medical personnel in training hospitals by their specific characteristics. Specifically this study attempted to find relevant determinants of the productivity of medical personnel using multiple stepwise regression analysis based on data obtained from 135 training hospitals. The findings of this study were as follows: 1) Daily average number of outpatients and inpatients treated by a physician were 20.4 and 10.2, respectively. 2) Daily average number of patients cared by a nurse was 8.2. Daily average number of tests performed by pathologic technician and radiologic technician were 83.2 and 21.5, respectively. 3) Productivity of medical personnel were significantly different for the three groups of factors: hospital sire (number of beds, number of medical personnel per 100 beds): institutional characteristics (medical school affiliation, training type, profit status); and environmental factors (location, number of physician and beds per 1,000 population in the region). 4) The factors a(footing the productivity varied according to the types of medical profession: the number if beds, the number of physicians per 100 beds, training type, and profit status for physicians; the number of nurses per 100 beds, the number of beds, medical school affiliation for nurses; the number of physicians per 100 beds, the number of technicians per 100 beds, and ownership for pathologic technicians; the number o( technicians, training type, and the number of physicians per 100 beds for radiologic technician.

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강명길(康命吉)의 생애(生涯)와 의학사상(醫學思想)에 대한 고찰 (A Study on the Life of Kang Myeong-gil and His Medical Theories)

  • 이정화
    • 한국한의학연구원논문집
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    • 제17권3호
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    • pp.25-34
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    • 2011
  • Gang Myeong-gil(康命吉) wrote Jejung sinpyeon(濟衆新編), one of three major medical books produced in the latter half of the Joseon Period. Jejung sinpyeon, edited at the behest of King Jeongjo, was intended to overcome the shortcomings of the then best medical book, Donguibogam(東醫寶鑑), and to update medical knowledge in a bid to spread that knowledge widely to the general public. Jejung sinpyeon contains the life and medical theories of the physician Gang Myeong-gil. In order to examine Gang Myeong-gil's life and medical theories, which influenced the edition and characteristics of Jejung sinpyeon, this paper studies his family lineage, medical records and the editorial characteristics of Jejun sinpyeon. Gang Myeong-gil and his ancestors served in government medical offices for some 200 years, and Gang Myeong-gil himself served as a physician at Naeuiwon for thirty years. His descendants also served as physicians upon passing the state-administered examination. Gang Myeong-gil preferred to prescribe drugs, and this inclination led him to include Yakseongga in Jejung sinpyeon, and he took an open and practical attitude towards the editing of the book. This approach is supported by the chapter on experience-based prescriptions in Jejung sinpyeon and the prescriptions of the Royal Infirmary, thus revealing his humanitarian and open thinking on medicine.

응급실 재원시간과 관련된 환자의 특성 (Patient characteristics associated with length of stay in emergency departments)

  • 정설희;황지인
    • 보건행정학회지
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    • 제19권3호
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    • pp.27-44
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    • 2009
  • The length of stay in emergency departments has been used as a quality indicator to reflect the overall efficiency of emergency care. Identifying characteristics associated with length of stay is critical to monitor overcrowding and improve efficient throughput function of emergency departments. This study examined the level of waiting time for initial assessment by physician and length of stay in emergency departments. Furthermore, we investigated the characteristics of patients' attendance associated with length of stay. An observational study was performed for a sample of 1,526 patients visiting ten nation-wide emergency departments. A structured form was designed to collect information about patients' demographics, route of admission, time and mode of arrival, triage level, cause of attendance, initial assessment time by physician, departure time, and disposition. Multiple regression analysis was performed to determine factors associated with length of stay. The average length of stay was 209.4 minutes (95% confidence interval [CI]=197.1-221.7), with a mean waiting time for initial assessment of 5.9 minutes (95% CI=5.1-6.7). After controlling for emergency department characteristics, increasing age, longer waiting times, attendance due to diseases, higher acuity, multiple diagnoses($\geq$2) and requiring admission or transfer to other health care facilities were positively associated with length of stay in emergency departments. The findings suggest that both patients' characteristics and the flow between emergency departments and parent hospitals should be taken into account in predicting length of stay in emergency departments.

법정전염병 신고행태 및 관련특성 연구 (A Study on the Physician's Behavior of Notifiable Communicable Diseases Reporting and its Characteristics Related)

  • 이윤현;맹광호
    • 보건행정학회지
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    • 제9권4호
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    • pp.41-64
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    • 1999
  • The major concern for this research is to discuss and to offer some solutions to bring the effectiveness of existing notifiable diseases reporting system over the physicians' attitudes of reporting, the actual condition of performance and the reasons of inertia in notifiable diseases reporting through examining the physicians of medical institutions in nationwide such as pediatrics, internal medicine and family medicine. The actual conditions of notifiable communicable diseases(NCD) reporting was surveyed by mail objectifying an internal medicine, pediatrics and family medicine in nationwide on the basis of stratified random sampling method divided into the classification of medical institutions and areas. As a result of survey. the rate of respondents showed 145 persons from physicians, 105 persons from hospitals. 120 persons from general hospitals, and 51 persons from tertiary hospitals. The total number of respondents were 421 and was rated 59.0 %. The analysis of collected survey went through a descriptive analysis primarily to grasp physicians' attitudes on the notifiable communicable diseases reporting, and then upon the dependent variables. Following are major findings obtained form the data analysis. 1. The results of a descriptive analysis on physicians' attitudes towards reporting NCD were as follows: First, the respondents who didn't know that yellow fever is reporting NCD were 11.0% of clinic, 10.5% of hospital. 5.0% of general hospital. 11.8% of tertiary hospital. and in case of hepatitis B, were 26.9% of clinic, 35.2% of hospital. 35.0% of general hospital. 23.5% of tertiary hospital. Second, The rate of physicians' knowledge on penalties of not reporting the NCD by their medical institution were 35.2% of clinic, 45.7% of hospital. 36.7% of general hospital. 62.7% of tertiary hospital. Third, among the no-reporting physicians in whole, the major reason of not reporting NCD were uncertainty of diagnosis(78.9%), no need to report(46.4%), no adequate actions from PHC(29.1%), no knowledge of the cases being notifiable ones in the order of their frequencies(30.4%), meddling from PHC(29.1%), concerning of patient's privacy(26.3%). 2. To analyze the characteristics related to the physicians' behaviors to report NCD, univariate and multiple logistic regression analyses were applied to the variables related to physician, 4 medical facility, PHC, and reporting system. The result were as follows: First, the result of the univariate analysis on physicians' attitude to report NCD and characteristics related to reporting in odds ratio was in the case of hospital. 3.4 times higher positive responses on physicians' attitude to report NCD came up as compared to the clinic. Second, the result of the univariate analysis on physicians' action of reporting NCD and characteristics related to reporting by the classification of medical institutions showed that the odds ratio of hospital was 2.3 times, the odds ratio of general hospital was 2.0 times, the odds ratio of tertiary was 6.8 times significantly higher than clinic. And the medical institution with significantly higher positive attitudes rate by multiple logistic regression analysis was hospital that rated 2.5 times significantly higher than clinic. Also in the PHC related characteristics of reporting, the rate of action in reporting NCD was significantly higher in medical institution that were endowed with the good condition of reporting. In multiple logistic regression analysis, the medical institution that has a good conditions of reporting showed a significantly higher positive rate on the action of reporting than the others.

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농촌지역주민의 암 조기검진과 관련 요인에 관한 연구 (Cancer Screening Rate and Related Factors in Rural Area)

  • 장성훈;이원진;이건세
    • Journal of Preventive Medicine and Public Health
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    • 제33권3호
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    • pp.364-372
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    • 2000
  • Objectives : Cancer is the second most frequent cause of death in Korea. Cancer screening tests can save lives through early detection. Enhancing the cancer screening rate is an important strategy for reducing cancer mortality. The purpose of our study was to evaluate the screening rate and related factors in a rural area. The study investigated relationships between sociodemographic characteristics, several preventive behaviors, and the experience of several cancer screening behaviors. Materials and Methods : The study population was recruited voluntarily from the three rural areas(Myen) in Chungju city. The participants completed structured questionnaire from July 21, 1990 to July 26, 1998. Results : The proportions of the study population who had previously received stomach, liver, breast, or cervix cancer screening tests were 24.5%, 18.5%, 27.0%, 59.2% respectively. The 1-year screening rates of stomach, liver, breast, and cervix cancer were 7.4%, 6.8%, 8.6%, 15.6% respectively. In multivariate logistic analysis, some sociodemographic variables, preventive behaviors, or psychological variables were significantly associated with several cancer screening tests. Those who had previously received a stomach cancer screening test were significantly associated with the presence of chronic disease, physician's recommendation, use of alcohol family history of cancer, or previous liver cancer screening test. Those who had previously received a liver cancer screening test were associated with education level, physician's recommendation and previous stomach cancer screening test. Those who had received a cervix cancer screening test were significantly associated with education level, presence of a transportation vehicle, physician's recommendation use of alcohol and previous breast cancer screening test. And those who had received a previous breast cancer screening test were significantly associated with age, marital status, and earlier cervix cancer screening test. Conclusion : Based on the results of this study a strategy to promote cancer screening and health objectives at the district level can be made.

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『황제내경(黃帝內經)』의 '종용(從容)' 의미에 대한 연구(硏究) (The Meaning of Jongyong(從容) in the 『Huangdineijing』)

  • 류정아
    • 대한한의학원전학회지
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    • 제33권4호
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    • pp.1-19
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    • 2020
  • Objectives : This paper aims to understand the meaning and utilitarian values of 'Jongyong(從容)' in medicine by studying its meaning in the 『Huangdineijing』. Methods : Examples of 'Jongyong(從容)' usages in Chinese literature and classical texts were studied first. Next, the similarities and characteristics of its contexts in discourses between Leigong and Huangdi were examined, followed by further examination of the overall meanings of the six chapters, 「Shicongronglunpian(示從容論篇)」, 「Zhuzhijiaolunpian(著至敎論篇)」, 「Shuwuguolunpian(疏五過論篇)」, 「Zhengsishilunpian(徵四失論篇)」, 「Yinyangleilunpian(陰陽類論篇)」, 「Jiejingweilunpian(解精微論篇)」 and the verses that include 'Jongyong(從容).' Results : Generally 'Jongyong(從容)' describes a resilient attitude that responds appropriately and calmly to difficult external situations while maintaining one's character, or refers to one's general behavior. In the 『Huangdineijing』, 'Jongyong(從容)' is only mentioned in discourses between Leigong and Huangdi, which talks about ancient East Asian clinical medicine in general, its transmission and education. Here, the meaning of 'Jongyong(從容)' could be summarized as an expansion of analogical thinking[引比類], medical work that involves the physician's commitment(人事), and detailed measurement of yinyang difference in the body(刑法, 陰陽, 治數). Discussion : In ancient East Asian medicine, the meaning of 'Jongyong(從容)' is closer to measurement of the yinyang difference rather than differentiation of the five element analogy. It is a medical practice that measures the shape, volume, length, area, height, concentration etc. of the human body in numerical figures to allow for the most subtle comparison, which was an important aspect of the physician's work that needed to be demonstrated, educated and transmitted to later generations to enable continuity of the medical profession.

리더십 교육훈련 프로그램 학습의 현장 전이 비교 연구 : 병원 의사와 기업 관리자를 중심으로 (Comparison Study for Learning Transfer Factors of the Leadership Training Program in Different Types of Job : Focused on Physicians in Hospitals and Managers in Firms)

  • 황재일;박병태;구자원
    • 한국병원경영학회지
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    • 제18권4호
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    • pp.54-77
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    • 2013
  • This paper is a comparison study about leadership training transfer factors between physicians working in large scale hospitals and managers working in firms. To fulfill this purpose, this study conducted a regression analysis on 101 managers and 59 physicians who had attended similar leadership training programs more than 16 hours recently in order to identify the differences on the learning transfer factors. 6 factors such as Learner readiness, Performance self-efficacy, (so far as Trainee Characteristics group), Organization Culture, Supervisor's tangible incentives and Supervisor's intangible support, (so far as Work environment group), Content Validity & Transfer Design (so far Training Design group) were used as independent variables while the personal Managerial Capability Increase and Leadership Capability Increase were used as dependent variables. And also we used 5 factors as control variables ; Job style (Manager or Physician), Age, Gender, Working years and Organization size. Here are the summary of major findings ; first, there were statistically significant differences between the learning transfer factors in leadership training programs for managers and those of physicians. Second, there were also statistically significant differences among trainees' working years and their organization size factors while age and gender do not affect the learning transfer factors. Third, for the physician's leadership training the practitioners should focus on two factors ; Organization Culture and Learner readiness.

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의료보험자료 상병기호의 정확도 추정 및 관련 특성 분석 -법정전염병을 중심으로- (Estimation of Disease Code Accuracy of National Medical Insurance Data and the Related Factors)

  • 신의철;박용문;박용규;김병성;박기동;맹광호
    • Journal of Preventive Medicine and Public Health
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    • 제31권3호
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    • pp.471-480
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    • 1998
  • This study was undertaken in order to estimate the accuracy of disease code of the Korean National Medical Insurance Data and disease the characteristics related to the accuracy. To accomplish these objectives, 2,431 cases coded as notifiable acute communicable diseases (NACD) were randomly selected from 1994 National Medical Insurance data file and family medicine specialists reviewed the medical records to confirm the diagnostic accuracy and investigate the related factors. Major findings obtained from this study are as follows : 1. The accuracy rate of disease code of NACD in National Medical Insurance data was very low, 10.1% (95% C.I. : 8.8-11.4). 2. The reasons of inaccuracy in disease code were 1) claiming process related administrative error by physician and non-physician personnel in medical institutions (41.0%), 2) input error of claims data by key punchers of National Medical Insurer (31.3%) and 3) diagnostic error by physicians (21.7%). 3. Characteristics significantly related with lowering the accuracy of disease code were location and level of the medical institutions in multiple logistic regression analysis. Medical institutions in Seoul showed lower accuracy than those in Kyonngi, and so did general hospitals, hospitals and clinics than tertiary hospitals. Physician related characteristics significantly lowering disease code accuracy of insurance data were sex, age group and specialty. Male physicians showed significantly lower accuracy than female physicians; thirties and fortieg age group also showed significantly lower accuracy than twenties, and so did general physicians and other specialists than internal medicine/pediatric specialists. This study strongly suggests that a series of policies like 1) establishment of peer review organization of National Medical Insurance data, 2) prompt nation-wide expansion of computerized claiming network of National Medical Insurance and 3) establishment and distribution of objective diagnostic criteria to physicians are necessary to set up a national disease surveillance system utilizing National Medical Insurance claims data.

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한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案) (Innovative approaches to the health problems of rural Korea)

  • 노인규
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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